Recovery Act Investments in Obesity

Public Health Burden

The increasing prevalence of overweight and obesity, especially among racial and ethnic minorities, is a serious public health concern. Today more than two-thirds of U.S. adults are overweight, and more than one-third are obese. The percentage of children and adolescents who have a high body-mass index (a measure of body weight in relation to height) has almost tripled during the past three decades and now stands at 16 percent. Excessive weight is associated with numerous adverse health outcomes, including heart disease and its risk factors (e.g., high cholesterol, high blood pressure, diabetes), sleep disorders, and lung diseases.

Achieving and Maintaining Weight Loss

Although many Americans indicate that they are trying to lose weight, most have trouble doing so, and many adults who are successful at shedding excess pounds eventually regain them. Recovery Act-funded grants that are exploring potential new approaches for achieving and maintaining weight control and thereby improving health include studies to:

• Develop and test a low-cost, interactive Internet program that can be used as a resource by physicians in providing weight-loss advice and feedback to patients.1
• Develop and test in overweight and obese young mothers a smartphone application called ANDWellness that uses GPS and an accelerometer to track and measure diet, exercise, and stress.2
• Evaluate the effectiveness of a low-carbohydrate/high-fat weight-loss diet versus a low-calorie/low-fat diet, alone or in combination with exercise, to improve early markers of heart disease in people with abdominal obesity. 3
• Identify factors that are important in helping adults maintain weight loss for up to five years after achieving it. This project extends the Weight Loss Maintenance Trial which found that personal counseling helped adults to keep weight off over two and half years, but the benefit of a Web-based intervention waned after two years.4
• Test the efficacy of self-monitoring to prevent reductions in spontaneous physical activity that can accompany weight loss and appear to be greater among women than among men.5

Prevention

Because reversing weight gain is problematic and often unsuccessful, prevention of overweight is critical. Recovery Act-supported research on prevention in various age groups includes studies to:

• Develop and test interventions for sedentary adults to increase physical activity and decrease TV viewing by providing feedback delivered via mobile phone technology.6
• Explore the relationship between taxes levied on food, beverages, or restaurant meals and people's dietary choices or body weight.7
• Evaluate the manner in which mandatory calorie labeling of foods affects caloric intake and consumer decision-making.8
• Explore how the home environment of adolescents influences their weight, food intake, and physical activity. This project, which capitalizes on an ongoing study of 2,400 adolescents, will provide insights to help parents guide their children in developing healthy habits. 9
• Identify and test strategies that foster physically active lifestyles among people of all ages in Orlando, Fla.—programs that could be readily adopted by other cities across the nation.10

Basic Research

Understanding how fat cells and circulating fatty acids function may lead to more choices for weight loss and cardiovascular disease risk reduction. Recovery Act funds are supporting projects to:

• Investigate how fat cells communicate with cells of the immune system to cause high blood pressure and atherosclerosis , and how physical activity disrupts this unhealthy communication.11
• Use genetically modified mice to understand how fatty acids provide energy to muscles of the heart and why an excess of fatty acids can sometimes lead to heart failure in patients with diabetes and obesity.12
• Improve understanding of why some people with obesity develop risk factors for heart disease, while others do not, by examining the contribution of genes that regulate proteins secreted by fat tissue. The results will provide new direction for development of therapies to prevent or reverse early vascular injury.13

1. 1 RC1 HL100002-01 - Innovative Technology to Improve Patient Adherence to Weight Loss Recommendations - Wing, Rena R (RI)
2. 1 RC1 HL099556-01 - Self-monitoring Using GPS- and Accelerometer-equipped Smartphones - Ramanathan, Nithya (CA)
3. 1 R01 HL092280-01A2 - Two Diets With Exercise in Abdominal Obesity: Cardiovascular Effects - Stewart, Kerry J (MD)
4. 1 RC1 HL099437-01 - Analysis of Five-Year Follow-up Data from the Weight Loss Maintenance Trial - Stevens, Victor J (OR)
5. 1 R21 HL097252-01 - Intervening on Spontaneous Physical Activity to Prevent Weight Regain in Women - Nicklas, Barbara J (NC)
6. 1 RC1 HL099340-01 - Modifying Physical Activity and Sedentary Behavior via Mobile Phone Technology - King, Abby C (CA)
7. 1 R01 HL096664-01 - Economic Contextual Influences on Population Diet and Obesity - Powell, Lisa (IL)
8. 1 R01 HL095935-01 - Influence of Calorie Labeling on Food Choice - Elbel, Brian (NY)
9. 1 R01 HL093247-01A1 - Project F-EAT: Families and Eating and Activity in Teens - Neumark-Sztainer, Dianne R (MN)
10. 1 R01 HL091793-01 - Get Active Orlando: Walking, Bicycling, Gardening - Dennis, Karen E (FL)
11. 1 R21 HL093663-01A1 - Influence of physical activity on leptin receptor expression in adult women - Cannon, Joseph G (GA)
12. 2 R01 HL073029-06A1 - Mechanisms of Fatty Acid Uptake By Cardiac Muscle - Goldberg, Ira (NY)
13. 1 R01 HL092030-01A1 - Inflammation and Injury in Obesity Hypertension in African American Adolescents - Falkner, Bonita (PA)

Last Updated April 26, 2010